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DocuSign Envelope ID:909E237B-463D-4B50-982B-EC089340083F <br /> 5. APPLICATION CHECKLIST (in this order;do not staple, bind, or put into individual folders) <br /> One copy:1 sided,81/2"x11", white paper <br /> 121 Application Form,including signatures <br /> 12/ Narrative <br /> Er Budget Sheet <br /> El Itemized Budget(if necessary) <br /> El Resumes of key artists and administrators involved in grant funded program(s) <br /> El Organizational Budget for current AND past two fiscal years <br /> El Artist contact list, including names,address, phone numbers, and email (if applicable)of all <br /> artists involved in grant funded activities <br /> 121 Staff roster with position title(s) <br /> 12/ Board contact list,including names,address, phone numbers, and email (if applicable)of <br /> organization's board of directors <br /> E9' Copy of IRS Tax Exemption Letter <br /> 12' Sample programs, press,or other materials from this or similar past programs <br /> Sample work by artist(labeled with artists' name,title of work,date of work) produced in the <br /> last three years: <br /> o Visual artists: CD, DVD,or high resolution photographs(5-10 images). Clearly label each 1, <br /> piece with dimensions and media and indicate top of image <br /> o Dance or theater artist: CD or DVD, or link to high-quality online video(3-5 minutes) <br /> o Music and spoken word: CD, MP3 or link to high-quality online video(3-5 minutes) <br /> o Literary arts: Manuscript(10-15 pages)submitted as .pdf file or hard copy <br /> 6. SIGNATURES <br /> Typed or Printed Name—Project Director: HUINA CHEN <br /> . � <br /> . NOVEMBER 30, 2016 <br /> Signature of Project Director Date <br /> IF <br /> Typed or Printed Name—Authorizing Official: XUEZHONG CAI <br /> f L <br /> NOVEMBER 30.2016 <br /> Signature ef Authorizing Official Date <br />